Reflections of a Pharmacy Practice Resident

ADS #3 – Patient Assessment

This session is one that I foresee myself referring to a great deal for the remainder of this year, and perhaps even thereafter during my practice as a clinician.

My biggest take home point from this ADS that I hope to really incorporate as soon as possible is: Assess each condition and drug in a head to toe approach with a thorough review of systems. This will help with monitoring, investigations, interventions, etc.

This will help me ensure that I haven’t forgotten anything when I work up my patient. This ADS also helped me realize why certain thought processes in my OEE rotation did not go as smoothly as I would’ve liked, something that I will certainly focus on during my clinical orientation (and for all of my DPC rotations).

Some ROS interesting things that I learned today:

Vitals

Mean Arterial Pressure (MAP) = (2*diastolic + systolic)/3

The mean is calcualted by dividing the sum by 3, because one spends twice as much time in diastole compared to systole.

Orthopenia – how many pillows they need to sleep on (to be elevated to not experience SOB that night).

Neuro: (investigations here are filled with acronyms galore)

GCS: Glasgow Coma scale; assessing consciousness.

when taking GCS its important to know which body systems contribute to the GCS score (e.g. eyes, movement, etc.)

MMSE: impt to have the pt be able to read, hear and know the language

If they take a while to answer you can adjust their score (e.g. if they say the right date, but doesn’t really seem like they know it, then you would continue to subtract the point).

Each body system was a great review of information, and even more so great clinical relevance was added to some knowledge that we already had to help us be more proficient when we apply this during our DPC rotations.

Can’t wait to tie all this info together tomorrow during our final ADS (Clinical Patient Workup and Therapeutic Thought Process) of our orientation week!